Sinus Headaches - Why You Get Them and How to Get Rid of Them for Good
Sinus headaches are caused by sinusitis, an inflammation of one or more of the para-nasal sinuses.
Sinuses are the air-filled cavities (spaces) located in the different places inside the face.
Sinuses secrete mucus that moisturises the channels of the nose. In the case of a sinus-inflammation (such as allergic reaction or infection), the outflow of mucus is prevented, which results in a build-up inside the cavities. This build-up stimulates the pain-transmitting nerve endings inside the membrane, which, through sensitisation, leads to a headache.
Sinusitis can occur as a complication of acute coryza (inflammation of the mucus membrane in the nose, caused especially by a cold or by hay fever), influenza, measles, scarlet fever, and other infectious diseases.
Sinusitis can be unilateral or bilateral, meaning the condition can affect the sinuses on one or both sides, respectively. The duration of sinus inflammation may be:
- acute - caused either by bacterial (purulent sinusitis) or viral (serous sinusitis) infection, and lasts up to four weeks
- chronic - lasting more than 2 months
Generally, sinusitis is caused by bacteria and viruses that cause inflammation of the upper respiratory tract. Acute sinusitis often occurs because of acute coryza, influenza, measles, scarlet fever, or other diseases of similar infectious nature. Acute sinusitis is more often seen in people with troubled nasal breathing, allergic rhinitis, and other diseases of the nose.
Acute sinusitis is more often seen in people with troubled nasal breathing, allergic rhinitis, and other diseases of the nose.
What type of sinusitis do you suffer from?
Sinusitis is usually characterized by common cold symptoms as malaise, weakness and fever, forms of acute and chronic sinusitis may also occur with:
- Purulent phlegm from the nose, having a greenish-yellow color, which may be an admixture of blood
- Severe nasal congestion
- Weakening of the sense of smell
- Strong dry cough, emerging at night
- Redness of the skin area, which is located on sinusitis
- Headache or facial pain
For acute sinusitis, pain is most common in the forehead, in the cheeks and lower eyes.
Chronic sinusitis may have the symptoms less severe than in acute sinusitis, but it runs longer.
Typically, chronic sinusitis is manifested by recurrent purulent discharge from the nose, nasal congestion desk, periodically emerging headache or facial pain and high susceptibility to colds.
A simple sinus headache self-test
You can also do a simple self-test for sinus headache. This isn't meant as a diagnostic tool, but it can be an indicator that the headache is indeed caused by sinus inflammation.
First a fair warning: After the test, your head might hurt a bit more for a while!
- Step one: close your nostrils with your thumb and index finger so that no air can go out in step two
- Step two: slowly blow the air out through your nose but don't allow any air to get out. Let the pressure inside your nose increase.
- Step three: reduce the air pressure and open your nostrils again
If the pain during step two decreased or even stopped for a moment and when you released the nostrils and established normal pressure inside the nasal cavity, the pain started again, focused on the area of the forehead just above the nose or in the area to either or both sides of your nose (in the cheek bones), then there's a high probability that the cause for your headache is sinusitis.
Again, the pain can increase for a while after doing this test! Also, if the pain doesn't stop, it doesn't automatically mean you don't have sinusitis.
How To Blow Your Nose Correctly
- Be in an upright position (sitting or standing up)
- Take a somewhat deeper breath and hold it while you prepare a tissue and place it on your nose with one or both of your hands (whichever way you prefer - I prefer to do it with one hand)
- Block one nostril with your thumb (or the tip of your index finger if you're using both hands to hold the tissue)
- Now slowly, with feeling, begin to increase the flow of the air through your nose (the one open nostril)
- You will feel when the flow is just right so that the contents of your nasal cavity begin to empty into your tissue
- Continue to blow until you run out of air or you think you got all that was possible out of your nose
- You can repeat the steps several times for each nostril.
Remember, it is very important that you initially slowly increase the flow of air through the nose and that when you get to the right flow, you keep it steady for as long as possible.
This way you will create a "suction" effect inside your nose and this will suck the contents of your sinuses out of them and into the tissue.
Avoid making a "trumpet sound," or creating a sudden, forceful increase of pressure inside your nose, when you're blowing it. This will cause the mucus to go into rather than out of your sinuses.
If your nose is too congested to get even a tiny amount out, consider using de-congesting nose drops or alternatively some strong mints, horseradish, wasabi (Japanese horseradish) or something similar.
Sinusitis diagnosis In the case of suspected sinusitis, diagnosis and treatment is prescribed by an ENT doctor. Diagnosis involves rhinoscopy (a painless examination of the nasal cavity) and skull radiography, to detect dimming of sinusitis.
There are also handheld ultrasound devices available specifically for detection of sinusitis but not many doctors have them and they are more of an indication tool rather than a diagnostic one.
A general practitioner sees many patients with acute sinusitis but often it is challenging for him or her to diagnose the condition properly because the symptoms of bacterial sinusitis overlap with viral sinusitis, and it is difficult to distinguish between the two conditions based only on a clinical examination.
Sinus treatment and prevention of sinusitis
Treatment primarily aims at halting the inflammatory process in the paranasal sinuses and clearing them of mucus and pus, which were the cause of swelling of the nose.
Most often, sinusitis is treated by medication, if medication does not bring the desired effect, then other forms of treatment are used. Most otorhinolaryngologists practice a combination of antibiotics and surgical (puncture) method.
Antibiotics are needed to treat the bacterial infection, and the puncture is needed to destroy the accumulations in the nasal sinus mucus and pus. It is a piercing into inflamed sinuses and their subsequent drainage and removal of the enlarged mucous membrane, which prevents proper ventilation of sinuses.
When applying the nose drops for inflammation reduction and alleviating the nasal congestion, make sure your head is tilted way back. If possible, try to lay on your bed with your head slightly tilting backward over the bed edge. Alternatively, put pillows under your upper back just below the neck so that your head is tilted back. Wait half a minute to a minute in this position. The drops will probably slowly come all the way to your throat. Don't worry, you'll spit them out. They taste a bit bitter but they will help.
This way you'll allow the drops to reach further back and have a stronger effect on your mucus membrane near and in the sinus area.
After applying the drops, they will open up your nose and your sinuses and help you get rid of the puss inside.
In the box on the right (below the picture of a woman blowing her nose), I wrote down the instructions on how to correctly blow your nose.
It almost hurts me when I see someone blow their nose forcefully and incorrectly, especially if they are making the "trumpet sound" when they are doing it. And it isn't only annoying and impolite to do in public, it's actually dangerous and can cause more trouble for you.
The "trumpet sound" and forceful blowing of the nose causes exactly the opposite of the desired effect.
Because of the sudden pressure created in the nasal cavity, the puss is more likely to force itself inside the sinus cavities rather than going out of them.
Another good way to clean your nose and sinuses is a simple device called Jala neti. It's a specially designed small pot where you put 0.9% salt water solution heated to about 37°C/98.6°F) and then pour it through your nose.
I have included a video demonstration of the use of Jala neti below.
The water will not only clean your nose, but also produce suction to pull mucus from your sinuses.
A 0.9% NaCl solution is 9 grams (or about one and a half teaspoon) of salt diluted in 1 liter of water.
See the table below to see approximate values you can use to make your solution, depending on how much solution you want to make:
Amount of solution
grams of NaCl
teaspoons of NaCl
1 liter (2 US pints)
0.5 liter (1 US pint)
0.3 liter (0.6 US pint)
Demonstration of the use of Jala neti to clean your nose and sinuses
I would recommend using Jala neti once a day the first three days and then about three times a week until your sinuses are cured. Please note that excessive use can cause irritation and thinning of your mucus membrane.
The best time to cure chronic sinusitis
This doesn't apply to acute and sub-acute sinusitis. If you get acute infection and sinus headache, you should deal with it immediately. It's best to visit your doctor and deal with the condition.
As for chronic sinusitis, it makes sense to plan ahead and start treatment in late spring or beginning of summer (also consider when you get the allergies if you do to plan treatment after the particular pollen is gone from the air). Treating chronic sinusitis takes some time (could be a few months) and it's best if you can have the weather to your advantage.
It also helps if you can go to the seaside. Sea water can be very beneficial in clearing your sinuses. Make sure that the sea is clean.
How to prevent sinusitis
1. Avoid fast temperature changes (more than 10°C/50°F). Remember, it's the DIFFERENCE in temperature and not the temperature itself that can cause you to get a cold and consequently sinusitis!
Even if it's in the middle of the summer and you step into a heavily air-conditioned place, you can catch a cold.
Because your body is adapted to the outside heat, stepping in a heavily air conditioned place can cause your outer layers (including the nasal cavity) to experience a sufficient drop in temperature to make it easier for viruses to attach themselves to the cells and cause disease.
2. Make sure you take your prescribed allergy medication when that time of the year comes. Allergies will also irritate and cause swelling of your mucous membrane in your nose and in your sinuses. It's enough to cause headaches and problems but it also provides a fertile ground for bacteria to cause further problems.
3. Blow your nose correctly (see the instructions above).
Relieve sinus headache with acupressure
Below I have included a video of acupressure points you can use to relieve a sinus headache. Acupressure is an ancient Chinese technique dating back more than 3000 years (some say even more than 5000 years).
After you locate each point, you should press on it with your finger relatively firmly (find your threshold for pain. Let it hurt but don't make it intolerable. Sometimes they will hurt - this is usually a good sign you're pressing the correct point for your issue). Press and hold each point for about one minute, then slowly release and gently rub the area you were pressing on.
It's important to relax while you're stimulating the points. It can also be helpful to visualize the energy flowing through the point you're stimulating and through the area you want to cure (in this case, your sinuses). This isn't necessary at all, but I find it useful, and many times I can feel the warmth at the place where I visualize the energy.
In the first video you'll discover some acupressure points on your face. Find each point and press on it for a minute. Then release it and go to the next point.
The second video doesn't have to do with acupressure, rather it's a bite-size tutorial on how to relieve sinus headaches as advised by a doctor.
I suggest you try the acupressure; it really helped me. Enjoy the videos.